Abstract：
OBJECTIVE: We aimed to assess the impact of the timing of urinary drainage on clinical outcomes in patients with obstructive pyelonephritis (OPN) associated with upper urinary tract (UUT) stones.
METHODS: We retrospectively evaluated the multicenter dataset of 240 patients with OPN associated with UUT stones who underwent urinary drainage. We divided the patients into two groups depending on the timing of urinary drainage; emergency drainage, defined as within 12 h from admission, and delayed drainage, defined as between 12 and 48 h from admission. The outcomes were the length of hospital stay, time to leukocyte normalization, and time to body temperature normalization. One-to-two propensity score matching (PSM) was applied to minimize the effect of confounders between the two groups. Subsequently, predictive patient factors for emergency drainage were analyzed using the logistic regression model.
RESULTS: Only the time from admission to normal body temperature was significantly shorter in the emergency drainage group when compared with the delayed drainage group (median: 2 vs. 3 days; p = 0.02), while there was no difference in time from drainage to body temperature normalization between the two groups. On multivariable analysis, high pretreatment C-reactive protein (CRP) was associated with implementing emergency drainage within 12 h.
CONCLUSIONS: The timing of urinary drainage was only associated with the duration of high fever, but it did not affect the postdrainage course. Emergency urinary drainage is more likely to be performed in severe patients, such as high pretreatment CRP.
METHODS: We retrospectively evaluated the multicenter dataset of 240 patients with OPN associated with UUT stones who underwent urinary drainage. We divided the patients into two groups depending on the timing of urinary drainage; emergency drainage, defined as within 12 h from admission, and delayed drainage, defined as between 12 and 48 h from admission. The outcomes were the length of hospital stay, time to leukocyte normalization, and time to body temperature normalization. One-to-two propensity score matching (PSM) was applied to minimize the effect of confounders between the two groups. Subsequently, predictive patient factors for emergency drainage were analyzed using the logistic regression model.
RESULTS: Only the time from admission to normal body temperature was significantly shorter in the emergency drainage group when compared with the delayed drainage group (median: 2 vs. 3 days; p = 0.02), while there was no difference in time from drainage to body temperature normalization between the two groups. On multivariable analysis, high pretreatment C-reactive protein (CRP) was associated with implementing emergency drainage within 12 h.
CONCLUSIONS: The timing of urinary drainage was only associated with the duration of high fever, but it did not affect the postdrainage course. Emergency urinary drainage is more likely to be performed in severe patients, such as high pretreatment CRP.
摘要：
目的：我们旨在评估与上尿路（UUT）结石相关的梗阻性肾盂肾炎（OPN）患者排尿时机对临床结局的影响。
方法：我们回顾性评估了240例OPN合并UUT结石患者的多中心数据集。根据排尿引流的时机将患者分为两组;急诊引流,定义为在入院后12小时内，和延迟排水，定义为从入院后12到48小时。结果是住院时间，白细胞正常化的时间，和体温正常化的时间。采用1对2倾向评分匹配（PSM），以最大程度地减少两组之间混杂因素的影响。随后，使用logistic回归模型分析急诊引流的预测患者因素.
结果：与延迟引流组相比，紧急引流组仅从入院到体温正常的时间显着缩短（中位数：2vs.3天；p=0.02），而两组从引流到体温恢复正常的时间没有差异。在多变量分析中，高预处理C反应蛋白（CRP）与在12h内实施紧急引流有关。
结论：排尿时间仅与高热持续时间有关，但并不影响后排水路线。重症患者更容易进行急诊尿引流,如高的预处理CRP。
方法：我们回顾性评估了240例OPN合并UUT结石患者的多中心数据集。根据排尿引流的时机将患者分为两组;急诊引流,定义为在入院后12小时内，和延迟排水，定义为从入院后12到48小时。结果是住院时间，白细胞正常化的时间，和体温正常化的时间。采用1对2倾向评分匹配（PSM），以最大程度地减少两组之间混杂因素的影响。随后，使用logistic回归模型分析急诊引流的预测患者因素.
结果：与延迟引流组相比，紧急引流组仅从入院到体温正常的时间显着缩短（中位数：2vs.3天；p=0.02），而两组从引流到体温恢复正常的时间没有差异。在多变量分析中，高预处理C反应蛋白（CRP）与在12h内实施紧急引流有关。
结论：排尿时间仅与高热持续时间有关，但并不影响后排水路线。重症患者更容易进行急诊尿引流,如高的预处理CRP。
